<!doctype html>
<html>
  <head>
    <meta charset="utf-8">
    <title>The Starbuzz Bean Machine</title>
  </head>
  <body>

    <h1>The Starbuzz Bean Machine</h1>
    <h2>Fill out the form below and click "order now" to order</h2>

    <form action="http://starbuzzcoffee.com/processorder.php" method="post">
		<p>
          Choose your beans:
            <select name="beans">
              <option value="House Blend">House Blend</option>
              <option value="Bolivia">Shade Grown Bolivia Supremo</option>
              <option value="Guatemala">Organic Guatemala</option>
              <option value="Kenya">Kenya</option>
            </select>
		</p>
		<p>
          Type:<br>
            <input type="radio" name="beantype" value="whole">
            Whole bean
            <br>
            <input type="radio" name="beantype" value="ground" checked> 
            Ground
		</p>
		<p>
		  Number of bags: <input type="number" name="bags" min="1" max="10">
		</p>
		<p>
		  Must arrive by date: <input type="date" name="date">
		</p>
		<p>
          Extras:<br>
            <input type="checkbox" name="extras[]" value="giftwrap">
            Gift wrap
            <br>
            <input type="checkbox" name="extras[]" value="catalog" checked>
            Include catalog with order
		</p>
		<p>
          Ship to: <br>
          Name:
            <input type="text" name="name" value=""><br>
          Address:
            <input type="text" name="address" value=""><br>
          City:
            <input type="text" name="city" value=""><br>
          State:
            <input type="text" name="state" value=""><br>
          Zip:
            <input type="text" name="zip" value=""><br>
		  Phone:
			<input type="tel" name="phone" value=""><br>
		</p>
		<p>
          Customer Comments:<br>
            <textarea name="comments"></textarea>
		</p>
		<p>
            <input type="submit" value="Order Now">
		</p>
      </form>
  </body>
</html>

